title: Implications of donor disseminated intravascular coagulation on kidney allograft recipients.
abstract: OBJECTIVE
  Disseminated intravascular coagulation (DIC) is common in deceased kidney donors and is considered a relative contraindication to donation. The significance of donor DIC on recipient kidney function is poorly understood. Additionally, the significance of thrombocytopenia in recipients of kidneys from DIC-positive donors is understudied.
  
  
  METHODS
  In a retrospective cohort of 162 kidney transplants, the presence of DIC in donors, the occurrence of thrombocytopenia in recipients, and risk factors for delayed or slow graft function (DGF/SGF) were assessed. The effects of DIC donor status on DGF/SGF in the study sample as a whole, and of thrombocytopenia on DGF/SGF in recipients of DIC-positive kidneys specifically, were examined using multiple logistic regression.
  
  
  RESULTS
  DIC donor status was not associated with occurrence of DGF/SGF, but thrombocytopenia was significantly associated with DIC-positive donor status (P=0.008). Thrombocytopenia was independently associated with DGF/SGF only in the recipients of DIC-positive kidneys (P=0.005). Patient and graft survival at 1 year were not affected by donor DIC status or by thrombocytopenia status.
  
  
  CONCLUSIONS
  Donor DIC was not associated with short-term suboptimal graft function, defined as DGF/SGF, nor with long-term patient or graft survival. However, thrombocytopenia appears to portend DGF/SGF in recipients of DIC-positive kidneys and may be a clinical sign on which the basis of therapeutic decisions could be undertaken.
authors.affiliation: Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. cwang@kumc.edu
authors.forename: Connie J
authors.initials: CJ
authors.lastname: Wang
authors.forename: Shahzad
authors.initials: S
authors.lastname: Shafique
authors.forename: Johanna
authors.initials: J
authors.lastname: McCullagh
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Diederich
authors.forename: Franz T
authors.initials: FT
authors.lastname: Winklhofer
authors.forename: James B
authors.initials: JB
authors.lastname: Wetmore
mesh_terms: D000328:Adult; D000368:Aged; D004211:Disseminated Intravascular Coagulation / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000453:epidemiology / Q000503:physiopathology; D014019:Tissue Donors / Q000706:statistics & numerical data*; D014184:Transplantation, Homologous